This project involves the comprehensive testing and monitoring of patient classification systems in the NIH Clinical Center. The patient classification system currently in place at the Clinical Center has been deemed inadequate by administration and staff of the Clinical Center. The inadequacy of the system has been validated by three outside experts. The experts have recommended that testing of three existing patient classification instruments should be carried out prior to the selection of one or more patient classification systems that best distinguish between patient groups. After testing has been completed in selected inpatient and outpatient settings in the Clinical Center, staffing coefficients will be developed for each nursing unit. Nursing units will be chosen based on their representativeness of current staffing patterns and activities of the Nursing Department, and in conjunction with Nursing Department staff. Reliability and validity will be established for the system selected, and a monitoring process will be put into place. An educational program will be developed for nursing staff so that the system can be maintained appropriately.